Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: PA and lateral views of the chest are provided . There has been interval placement of a dual - lead pacer device with pacer pack in the left chest wall and dual leads extending into the expected location of the right atrium and right ventricle . Cervical fusion hardware is partially imaged in the lower cervical spine . The lungs are clear without focal consolidation , effusion , or pneumothorax . No signs of CHF . Cardiomediastinal silhouette is normal . Bony structures are intact . No free air below the right hemidiaphragm .
    OUTPUT:
    
No acute intrathoracic process . Interval placement of dual - lead pacer with lead tips extending into the right heart .