left-sided pectoral icd -- the generator is rotated approximately <unk> degrees in position compared to the prior study. the lead follows a similar course. clinical correlation requested. heart size is at the upper limits of normal or slightly enlarged. the cardiac silhouette actually appears slightly larger than on the prior study, though this could also be accentuated by differences in positioning and/or could relate to different phases of the cardiac cycle. no acute pulmonary process identified.