Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Permanent pacemaker is present with leads in the right atrium , right ventricle , and a third lead for biventricular pacing . There is no evidence of pneumothorax . Cardiac silhouette is mildly enlarged but stable in size . Pulmonary vascularity is within normal limits . Longstanding loculated left pleural effusion appears similar to prior studies as well as smoothly marginated pleural opacity extending from the left apex along the lateral pleural surface , corresponding to increased extrapleural fat on prior CT torso of ___ . Right lung and pleural surfaces are clear .
    OUTPUT:
    
1 . Biventricular pacer in standard position with no pneumothorax . 2 . Chronic loculated left pleural effusion and extrapleural fat .