I hate a loud computer, so I replaced the stock fan on my 4870x2 with a 120mm, and I'm using a fan header on my Abit mobo to control it. Result is that at gpu clk = 800 Mhz, 30 minutes into crysis I can just barely hear the fan at all...with speakers turned off! I am absolutely shocked that this works so well, the fan is turning at about 1000RPM with no artifacts/crashing/high temps while in the heaviest games. The key is that ATI left the top of the HS open so that the air from my 120mm blows straight down into/between the HS fins. Before this mod, the stock fan was earsplitting. And the best part is that the second I get out of the game, the RPM drops to 600 RPM cause it's controlled by the mobo header which is referenced to CPU temp, not sys temp. So on desktop, it's like "is this thing even running?"
Even if you have a non-Abit mobo, you can still reference CPU temp by piggy-backing the vid card fan on the CPU header, just make sure you have a PWM fan, not a DC fan.
I tried this same mod on the gtx280 I used to have, didn't work nearly as well due to the ineffectiveness of the nvidia HS.
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