Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: There is a dual - lead pacemaker / ICD device in similar position with leads again terminating in the right atrium and ventricle , respectively . The heart is normal in size . The aortic arch is calcified . The mediastinal and hilar contours appear unchanged . The lungs appear clear . There is no pleural effusion or pneumothorax . Mild degenerative changes are similar along the mid thoracic spine , and slight wedging of a mid thoracic vertebral body also appears unchanged .
    OUTPUT:
    
No evidence of acute disease .