OK here's a laundry list of things to do

1) Make sure your cam timing is correct. If you are shooting with the poundage baacked off this can make broadhead tuning more difficult with a single cam bow that has less than optimal nock travel ( I don't know what year your PAT is, but the 2003/2004/5 models are better for nock travel than the 2002s). It's not impossible however.

2) Idler lean.2 schools of thought. Some folks want the string to track straight off the idler at rest. Others want it tracking straight at full draw. IF the string is coming off at an angle you can adjust either side of the split harness to to bring things back in line. I set the idler at rest, not at full draw

3) Arrows. Your spine seems OK. I don't think you would have an issue. Make sure you are shooting with plenty of helical (not offset) fletch. If you must use an offset to get it clear your nondropaway, then use a BIG fletch. 5" feathers or vanes. At the speeds you are shooting, you need all the stabilization you can get.

4) More arrows. Make sure you have STRAIGHT arrows. Carbon arrows are RARELY straight enough for great accuracy with fixed blades at high speeds unless you are using the premium super straight shafts.

5) Even more arrow stuff: Inserts. They MUST be in straight. At those speeds there cannot be ANY wobble of the broadhead. Use a tool like the Montec thing or the "Sand stone" from Easton ST Axis arrows to ensure the shaft is squared off properly. It also helps to do this on the nock end.

6) Make sure you are shooting a loop, and not off the string.

7) I would really recommend the drop away. This way you can some serious helical on the arrows. If you go that route, contray to what you might think, you want the rest to stay up for quite a aways instead f dropping instantly.Becauseof the nock travel, the arrow i pushed down and then back up If the rest drops too quick this causes all kinds of havoc..as the arrow crashes down....it needs a bit more guidance/direction.

As I said, at 290 FPS on a single cam with some nock travel, and shooting fixed blade heads there is NO margin for error in tuning or shooting form. Personally with that kind of energy and at those speeds I would shoot a mechanical to add some forgiveness when actually hunting and things are not perfect.However you still need toget the arrow flght and arrow issues solved first, as a poor flying mech is bad news, no matter how much speed & energy is involved.

Exact details of your setup would help.