pa_held is physical audio though, when it's full it's very roughly \~25ms usually. That would be a loud and annoying crackle happening every half an hour, or worst case much often. There has to be a way to somehow solve this without compromising anything.
Why loud? That is supposed to be just a ps_held length skip in audio, without loud garbage added. But anyway, I would agree that it is not ideal, it would be better to understand why time difference builds up and fix that. Currently it is supposed to catch up with app's visible mmdevapi audio quantum interval slightly dynamically adjusted, if that doesn't happen it is interesting why exactly and probably that is the part which should ideally be fixed one or another way.
quant 480 for pipewire-pulse
Which exactly units and parameter is that? What is the minimum period our mmdevapi actually ends up with? If that is more than 10 ms (stupulated by pulse latency) this can't work right now. We did have examples of issues (at least on Proton tracker) with such setup just breaking games (due to too high device period which never happens on Windows). -- https://gitlab.winehq.org/wine/wine/-/merge_requests/10792#note_138672