I've got a bt878-based TV card (Hauppauge WinTV, no radio) and a GeForce 4, and I can't say I've experienced any of the problems you describe...
I'm using kernel 2.4.20 and NVidia driver 4191 with the kernel AGPGART module.
Out of interest, are you running bttv with Xv enabled or disabled? Have you got the "extmod" and "v4l" modules set to load in your XF86Config?
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