Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a dual - lead pacemaker / ICD device with leads in similar positions , terminating in the right atrium and ventricle , respectively . The heart is at the upper limits of normal size . The mediastinal and hilar contours appear unchanged . There is no pleural effusion or pneumothorax . The lungs appear clear . Small osteophytes are noted along the mid - to - lower thoracic spine .
    OUTPUT:
    
No evidence of acute disease .