Did you make sure to delete the Fallout.ini file located in My Documents>My Games>Fallout3?
And did you make sure to uninstall the old drivers completely before installing the new card? How hot is it getting when in game?
Thanks for the reply!
I didn't delete the .ini file, but the game did detect the change and ask me for the DVD so it could run the setup again. Falloutprefs and RendererInfo definitely specify GTX460 now, and I did delete the old drivers. Heat is not a problem, got good cooling to the card, entire case is well cooled, and it's doing it straight after I get into the game, not cumulative.