what i wanted to know was do you need the AT-ATX converter?
Not if you get one of the newer ones like SX or TX. You only need the converter if the Mediator board is one of the old ones with a P8 and P9 connector (like the LT4 and earlier boards).
Also if you get a TV card with the mediator can you route the amiga native video into that and then display it on your screen? sort of like a way of getting around not having a scan doubler.
For WHDLoad games, yes, but for early boot menu and disk loaded games, no.