Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A left chest wall pacemaker is seen with leads in the right atrium and the apex of the right ventricle . There is no pneumothorax , focal consolidation , or pleural effusion . The cardiomediastinal silhouette is normal . There are no acute skeletal abnormalities . Degenerative changes are noted in the thoracic spine .
    OUTPUT:
    
New pacemaker with leads in appropriate position . No pneumothorax .