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 PHD PHD or False PHD False PHD can allow some pill effects to be activated twice by taking two different pills that activate the same effect.
  • If Isaac uses cards that convert/destroy pickups (such as Ace of Spades Ace of Spades, Black Rune Black Rune, IX - The Hermit? IX - The Hermit?, etc.), any other cards Echo Chamber activates that generate pickups have a high chance to have their pickups converted.
  • 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.
  • If an item is somehow removed and reobtained during the run (such as when obtained from Lemegeton Lemegeton or Modeling Clay Modeling Clay), all of the consumable types used during the time Isaac had Echo Chamber will be remembered.
  • A card, rune, or pill must be consumed for the effect of Echo Chamber to trigger. That means using Blank Card Blank Card, Placebo Placebo, or Clear Rune Clear Rune will not trigger Echo Chamber.


  • ? Card ? Card + Ancient Recall Ancient Recall / Vurp Pill + 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 Clicker Clicker) obtain completion marks for multiple routes and characters in a single run.
  • Ancient Recall Ancient Recall: Can be used to spawn infinite cards.
  • 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.
  • PHD PHD, Virgo Virgo, or Lucky Foot Lucky Foot: All activated pills are converted to their good counterparts, including pills taken prior to picking up PHD PHD, Virgo Virgo, or Lucky Foot Lucky Foot.
  • R Key R Key: Using the R key does not reset the consumable pool, as such they stay the same in Echo Chamber too.
  • Rune of Jera Rune of Jera: Allows for infinite duplication of items and consumables.
  • Tarot Cloth Tarot Cloth: Every activated tarot card will be given a bonus effect
  • Vurp Pill: Can be used to spawn infinite pills.


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

1V1X PNQ6 Eden starts with this item

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.
  • This is also possibly a reference to the card Echo Form from 'Slay the Spire', which will duplicate the card effect of the first card played per turn.