Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: The left - sided two - lead cardiac pacemaker device appears intact and unchanged in position , with one tip terminating in the right atrium and the other tip terminating in the right ventricle . Median sternotomy wires , surgical clips , and cardiac valve replacements appear intact and unchanged in position . The right IJ also appears intact and unchanged in position . Since ___ , the left - sided pleural effusion and adjacent compressive atelectasis have improved . Elevation of the left hemidiaphragm persists and is secondary to underlying left lung atelectasis . The lungs are otherwise clear , without focal consolidation or overt pulmonary edema . No pneumothorax . Stable moderate cardiomegaly . Stable post - procedural appearance of the mediastinum .
    OUTPUT:
    
1 . Upper open positioning of the recently placed pacemaker leads . 2 . Decreased , now small left pleural effusion with adjacent atelectasis compared to ___ .