I use a zalman passive heatsink on a Radeon AIW (Not the new series), and found that with a large slow fan mounted in the front of the case, and the blanking plate removed from the top PCI slot, there is a nice stream of air over the heatsink.
Been running like this for about 6 months, with HTPC on 24 X 7
After using mine for a few hours I got in the mood to do some modding. Shut down and popped out the card. Gave the heatsink a little twist and it came right off. Not sure if it was so easy because it was hot. BTW, the stock heatsink was terrible - you will notice how uneven the glue was. Which means very little heat transfer. I put on a passive heatsink from an old pentium pro with thermal paste and a tiny dab of superglue. Works great for me. Takes 2 pci slots and I took the slot covers off to allow the case fan to pass some air through it.
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