Melee combat is okay, but archery is just plain impossible, it seems to swerve to the left a little.
I imagine it would be impossible for the Thumbstick controls on the 360.
Slowing down time seems like a necessity if you want to be a horseback archer.
I honestly think people are misinterpreting the intention of Mounted Combat in Skyrim. It's not supposed to be a substitute for regular combat, it seems to just make horses less irritating by allowing you to beat down weaker enemies without dismounting. A real Fight on horseback against something like a Giant or Dragon, or even a group of bandits isn't going to end well for you or the horse.