Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Again seen is a left - sided pectoral ICD . The generator itself has rotated with respect to the prior study . The single lead is grossly similar in course . Heart size is at the upper limits of normal or slightly enlarged . Compared to ___ . The cardiomediastinal silhouette is slightly more prominent . No CHF , focal infiltrate , or effusion is identified . No pneumothorax detected . Previously seen atelectasis the right cardiophrenic region has resolved .
    OUTPUT:
    
Left - sided pectoral ICD -- the generator is rotated approximately ___ degrees in position compared to the prior study . The lead follows a similar course . Clinical correlation requested . Heart size is at the upper limits of normal or slightly enlarged . The cardiac silhouette actually appears slightly larger than on the prior study , though this could also be accentuated by differences in positioning and / or could relate to different phases of the cardiac cycle . No acute pulmonary process identified .