Binding of Isaac: Rebirth Wiki
Binding of Isaac: Rebirth Wiki

Added in Repentance

Echo Chamber is a passive item added in The Binding of Isaac: Repentance.


  • When using a pill, card, or rune, Echo Chamber activates one of every pill type, card type, and rune type that has been previously used since obtaining Echo Chamber.


  • Previously used cards, pills, and runes are effectively used again, meaning items that modify the effects of cards, pills, or runes will also modify the effects that Echo Chamber activates.
    • As a result, previously taken golden pills and blank runes will activate a random effect each time Echo Chamber activates them.
  • Regardless of how many times a single type of card, pill, or rune has been used previously, it will only activate the effect once.
    • Using items that convert pill effects into their good/bad counterparts such as 15►PHD PHD or 15►False PHD False PHD can allow some pill effects to be activated twice by taking two different pills that activate the same effect.
  • It is advised to avoid using cards that teleport Isaac, as he will be teleported to a specific room every time he uses a consumable. This effectively negates any current-room effects from consumables, such as XV - The Devil XV - The Devil or Rune of Algiz Rune of Algiz, as Isaac is teleported after they activate.
    • Similarly, it is also advised to avoid using unidentified pills, as Isaac runs the risk of activating either a stat down or Telepills every time he uses a consumable.
  • When obtained on Tainted Lazarus, Echo Chamber will only duplicate cards or pills previously used on the Lazarus state with Echo Chamber. As a result, teleport cards or Telepills can be freely used on the Lazarus state without Echo Chamber.


  • Ancient Recall Ancient Recall: Can be used to spawn infinite cards.
  • Rune of Jera Rune of Jera: Allows for infinite duplication of items and consumables.
  • ? Card ? Card + Ancient Recall Ancient Recall / Vurp Pill + 15►R Key R Key: The ? Card effect can be used in conjunction with R Key without consuming it, allowing the player to in theory (with the help of 15►Clicker Clicker) obtain completion marks for multiple routes and characters in a single run.
  • 15►R Key R Key: Using the R key does not reset the pill pool, as such they stay the same in Echo Chamber too.
    • Victory laps do reset the pill pool, all pills inside of echo chamber use their new effect.
  • Vurp Pill: Can be used to spawn infinite pills.
  • 15►PHD PHD, 15►Virgo Virgo, or 15►Lucky Foot Lucky Foot: All activated pills are converted to their good counterparts, including pills taken prior to picking up 15►PHD PHD, 15►Virgo Virgo, or 15►Lucky Foot Lucky Foot.
  • 15►False PHD False PHD: Taking benign pills (e.g. puberty) will give black hearts or damage ups for each of the pills that are activated. Caution should be exercised when using this synergy, since all previously taken pills will be converted to their bad counterparts, and one stat down can ruin the synergy.
  • 15►Tarot Cloth Tarot Cloth: Every activated tarot card will be given a bonus effect


YAZ7 ZEP9 First secret room (left of room before boss)

In-game Footage[]


  • This is possibly a reference to the card Eye of the Storm from Magic: the Gathering, as the item resembles the art of the card and both result in previous effects being reused when a new one is activated.

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