Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: In comparison with chest radiograph from ___ , there is no relevant change . Left - sided cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle . There is no focal consolidation , effusion , or pneumothorax . Mediastinal and hilar contours are stable . Heart size is normal .
    OUTPUT:
    
Left - sided cardiac pacing device with dual leads following their expected courses to the right atrium and ventricle , unchanged since ___ .