Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Cardiac pacemaker leads project over the right atrium and the right ventricle . Tip of the interrupted right - sided VP shunt is at the level of the aortic arch . Heart size is top normal . The mediastinal and hilar contours are normal . The pulmonary vasculature is normal . Left platelike scar is similar to prior . Biapical pleural scarring is worse on the left . Calcified granulomas are seen in the left apex . No pleural effusion or pneumothorax . Calcified aorta is again seen .
    OUTPUT:
    
Cardiac pacemaker leads project over the right atrium and the right ventricle .