I'm an ATI guy hands down. I have used Nvidia cards in the past, but I really like the ATI cards better. That is my opinion though.
As for the noise factor, that would be a problem if I cared.
The fact that ATI has been making a video card that offers DVD playback through hardware for a long time, and have multiple output options standard (until recent times, Nvidia never offered this) makes ATI the best card for me. As for Games, I have always been pleased with the image I see on my screen from both cards. I honestly don't think that there are all that many differences anymore between the two visually.
Good luck in your choice.