Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral chest views have been obtained with patient in upright position . Comparison is made with the next preceding chest examination of ___ . On the present examination , one can identify a newly placed permanent pacer in left anterior axillary position , seen to be connected with two intracavitary electrodes terminating in a position compatible with mid anterior portion of the right atrial wall and the second terminating in the apical portion of the right ventricle . Thus the position is good provided that good contact has been established . The heart size is mildly enlarged with a configuration favoring the left ventricle . The thoracic aorta is moderately widened and elongated but no local contour abnormalities are seen . The pulmonary vasculature is not congested , and no acute pulmonary infiltrates are seen . An unclear finding consists of a double large size metallic ring structure overlying the heart shadow on the frontal view . On the lateral view , a metallic singe ring projects in the ___ the heart shadow and another square metallic structure is located posteriorly to it . It is concluded that all these metallic structures are not belonging to the pacemaker device , but most consistent of external devices that have been moved between the taking of the frontal and lateral views .
    OUTPUT:
    
Unchanged heart size . Pacer with dual electrodes in appropriate position . No pneumothorax . Ref . cardiologist was reached by telephone at time of dictation .