The Good News:
My quest for an perfectly stable frame rate came to a successful conclusion earlier today. Setting it up to run at factory designed 30fps just like it does in it's native console homeland. This gives me rock solid, stutter free gameplay. It also seems to make the game more stable, but this could be placebo effect. 
NVIDIA Profile Inspector:
Frame Rate Limiter: 31.5 FPS
Maximum pre-rendered frames: 8
Triple Buffering: On
Vertical Sync: 1/2 Refresh Rate
Vertical Sync Tear control: Adaptive
The Bad News:
CASM is a save manager located on the nexus:
http://www.nexusmods.com/newvegas/mods/45652/?
The new refresh rate causes CASM to stutter like crazy unless you disable it's features that utilize a "scanner". Ex: Save when you Level Up, Save when you advance a challenge, Save when you craft an item, Save after hacking a terminal, and Save after picking a lock.
Luckily these can all be disabled, however it has an issue when you specify a value for minimum life for autosaves, it displays an invalid value that can't be edited.
The Question:
I expect the base game to be fully compatible with 30Hz gameplay as it was originally designed to function in exactly in that manner on consoles, however I understand a LOT of work had to be done "under the hood" to get TTW in it's polished state, are there any "scanner" issues I should worry about?
EDIT:
Attached some eye candy, this is not only smooth and highly playable, I am running a anti-aliasing called: 8x [8x CSAA (4 color + 4 cv samples)] Running vanilla textures currently and it looks amazing.
This is a laptop with a mobile GPU, if anyone has a lower end system this should let you play in much higher settings than you had dreamed of.
It requires a 750 or higher, and on a laptop it is unsupported so you'll need to use the Profile Inspector.
https://www.geforce.com/hardware/technology/adaptive-vsync/supported-gpus
