Summarize the radiology report findings into an impression within 3 sentences.
    INPUT: A DUAL LEAD LEFT - SIDED PACEMAKER IS PRESENT , LEAD TIPS OVERLYING THE RIGHT ATRIUM AND RIGHT VENTRICLE . NO PNEUMOTHORAX IS DETECTED . DOUBT SIGNIFICANT INTERVAL CHANGE . PROBABLE BACKGROUND COPD . NO CHF OR FOCAL CONSOLIDATION DETECTED . MINIMAL ATELECTASIS IN THE RIGHT CARDIOPHRENIC REGION AND BLUNTING OF THE COSTOPHRENIC ANGLES POSTERIORLY .
    OUTPUT:
    
AS ABOVE . .