options nvidia NVreg_RegistryDwords=RMLockingMode=1 was used in an attempt to resolve the issue alongside setting the CPU gov to performance state.
Some mild stutter under extreme loads was improved but the visual swim or drag was still present with seemingly no effect on it, the sensation like the lease is being double composited.
SteamVR appears to variably swim while monado seems to be fairly consistent in how it wobbles and the U_PACING_COMP_MIN_TIME_MS=10 env var on monado appears to move the sensation from maximally sickening to mildly sickening. Substantial improvement from there reported, when user switched to AMD.
A secondary issue worthy of mentioning is some people with VRR capable monitors enabled and working appear to experience tearing in HMD while VRR is active in kernel or in userspace. Disabling VRR at any of these stages prevents the tearing in the HMD.