IMPRESSION:
Heart size is normal.  Mediastinum is normal.  Lungs are clear.  There is no
 pleural effusion and pneumothorax.
 
 Left-sided newly inserted pacemaker is demonstrated in expected position with
 the a right atrial leads terminating in the expected position and the right
 ventricular pacemaker defibrillator leads terminating in the expected position
 as well.