1. Set the custom keyboard shortcut sh -c 'pgrep -i keepassxc > /dev/null || keepassxc' to Alt+V
2. Keep KeePassXC’s default autotype prompt keybinding, which is Alt+V

One disables the other. I thought that going the grep route might make the program opener conditionally inactive, but apparently that’s not doing anything. I would really like to avoid using a separate keybinding if possible. Otherwise, I guess I’d just have to have it open on launch.