I'd be interested as to how dumb-ol' polling would compare here (the FOR UPDATE SKIP LOCKED method https://leontrolski.github.io/postgres-as-queue.html). One day I will set up some benchmarks as this is the kind of thing people argue about a lot without much evidence either way.
Wasn't aware of this AccessExclusiveLock behaviour - a reminder (and shameless plug 2) of how Postgres locks interact: https://leontrolski.github.io/pglockpy.html