I'm using the Vista Premium and X-Fi Extreme Music sound. I downloaded the latest driver about 2 days ago and I played the games now like 2142, Counter Strike, Call of Duty 2, FEAR and Oblivion. It runs great and I don't have any problems with it.
In addition to the driver, I also downloaded and installed the Creative Console Launcher and Creative Alchemy (X-Fi Edition) and it works great as well.