I have an Accelero on an x1900Xt which sets up the same as yours, get an Antec Super Cyclone exhaust fan. It lines up perfectly with the exhaust heat from the Accelero and gets all that heat out of the case . You will notice a huge difference.
It is true that the accelero is more for lower noise than supreme thermal capabilities but it still performs better than stock and a lot quieter too. I'd keep it in. The exhaust fan is a good idea if the heat from the vid card is taxing your other components. Plus...the one tallman mentioned is among the quieter ones.
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