Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: Left - sided dual lead pacer device is again seen , unchanged in position . The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged . No large pleural effusion or pneumothorax is seen . No definite focal consolidation . No overt pulmonary edema .
    OUTPUT:
    
Left - sided dual lead pacer device is again seen , unchanged in position . The cardiac and mediastinal silhouettes are stable with the cardiac silhouette enlarged . No large pleural effusion or pneumothorax is seen . No definite focal consolidation . No overt pulmonary edema .