Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Permanent pacemaker remains in place , with leads in the right atrium and right ventricle , and no evidence of pneumothorax . Heart is normal in size with left ventricular configuration . Lungs are clear except for minimal symmetrical biapical thickening and a calcified granuloma in the right middle lobe , both unchanged since ___ .
    OUTPUT:
    
Permanent pacemaker leads terminate in right atrium and right ventricle , with no evidence of pneumothorax .