Binding of Isaac: Rebirth Wiki

Isaac's Heart is an unlockable passive item.


  • Isaac's body becomes immune to all damage.
  • A heart familiar appears and closely follows Isaac. If the heart is hurt, Isaac is hurt.
  • Added in Repentance The heart tries to position itself in the opposite direction of where Isaac is shooting.
  • Added in Repentance The heart charges up as Isaac fires. At full charge, upon releasing the fire button, it knocks back nearby enemies and tears, creates a small puddle of red creep on the ground, and releases blood shots in 8 directions that deal 8 damage.
  • Added in Repentance Enemies that come in contact with Isaac take 2x Isaac's current damage per tick or 4x Isaac's damage per second.
  • Removed in Repentance Most enemies now target the heart instead of Isaac. Eye Eyes and other similar enemies, however, will still target Isaac.


  • Removed in Repentance Blood Donation Machines and Devil Beggars can be used for free.
    • During Added in AfterbirthThe Guardian The Guardian challenge, Devil Beggars and Blood Donation Machines deal damage to Isaac.
  • Spikes, Curse Room Curse Room doors and Added in Afterbirth Spiked Chest Spiked Chests do no damage. Sacrifice Room Sacrifice Room spikes still work, though the heart has to go on the spikes instead of Isaac. The door to Mausoleum Mausoleum / Gehenna Gehenna is not affected.
  • Picking up a non-orbital familiar will cause either Isaac's Heart or the other familiar to be layered over the other's sprite. This is due to the heart not taking up the spot that the other familiar follows in.
  • Co-op babies gain the immunity effect without spawning additional hearts.
  • Removed in Afterbirth Enemy Brimstone shots (such as from The Bloat The Bloat) will not do any damage to the heart.
  • The tracking lasers from Added in Afterbirth Hush Hush and light pillars from Isaac Isaac do not damage the heart.

Tips and strategies[]

Items / Trinkets[]

  • Items that activate on contact with enemies retain their ability, allowing Isaac to use them without suffering collision damage.
  • Removed in Repentance Items that hurt Isaac on activation, such as IV Bag IV Bag and Blood Rights Blood Rights no longer do so, allowing infinite uses for free.
  • Removed in RepentanceGet 5 cents as soon as possible so an Arcade Arcade can show up, Blood Donation Machine.png Blood Donation Machines and IV Bag IV Bag are the best and most common ways to win Isaac's heart run.
    • Added in Afterbirth † If Added in Afterbirth Lucky Penny Lucky Pennies are unlocked, it may be beneficial to immediately try to gain 10 luck or more via the IV Bag to maximize room drops and enhance tear effects.
  • Speed up items are invaluable when having Isaac's heart since the delay between the player moving away and the heart moving as well gets drastically reduced. Avoid speed down items early in the run.
  • Orbital familiars are invaluable as Isaac can get extremely close to the enemy without fear of contact damage.
  • Flight items are invaluable as the heart can be placed over a rock and Isaac can stick out enough to shoot at enemies without needing spectral tears.
  • Angel Rooms are safer bets for items than Devil Rooms.

Combat and Damage[]

  • Hug obstacles to avoid taking damage. Look out for enemies that fly or can jump over rocks, and make sure enemies don't push Isaac far away from his heart to expose it.
  • When dodging, Isaac must move in semi-straight lines as the heart only follows Isaac's movements when he is at a certain distance away, for example, moving in a circle would pull the heart in and make it stay in place in the middle of the arc as Isaac would no longer be moving away from the heart. Moving in a triangle formation would allow the heart to move more.
  • Enemies that fly and charge like One Tooth One Tooth are extremely hard to dodge and should be killed as soon as possible, take caution since they can appear as early as Caves Caves / Catacombs Catacombs.
  • Enemies can be pushed away with Isaac's body, while not recommended, it can be used as a last resort.


  • Added in AfterbirthBox of Friends Box of Friends: Box of Friends does not duplicate the heart, making it safe to use.
  • Removed in RepentanceBreath of Life Breath of Life: Isaac can be infinitely invulnerable, as invincibility carries out to the heart without hurting the player. Note that the item needs to be activated for longer than one second for the invulnerability to kick in, however.
  • Added in Afterbirth †Duct Tape Duct Tape: Makes dodging significantly easier.
  • E. Coli E. Coli: Isaac can turn enemies into poop without taking damage.
  • Gnawed Leaf Gnawed Leaf: Invincibility carries over to the heart.
  • Holy Mantle Holy Mantle: The shield effect carries over to the heart.
  • Removed in RepentanceIV Bag IV Bag: Can be used without taking damage, resulting in an infinite amount of coins.
  • Kamikaze! Kamikaze!: As long as the heart is away from the blast radius, no damage is taken. The character must be at high enough speed for this.
  • Removed in RepentanceRazor Blade Razor Blade: Isaac cannot take damage from the Razor Blade, allowing for infinite uses of the item.
  • Added in Afterbirth † / Removed in RepentanceSacrificial Altar Sacrificial Altar: Can remove the Isaac's Heart familiar while the item remains, making Isaac invulnerable.
    • Added in Repentance Sacrificial Altar now doesn't remove Isaac's Heart.
  • Added in AfterbirthSerpent's Kiss Serpent's Kiss: Isaac can poison enemies by contact without taking damage, allowing for free black hearts.


  • Added in Afterbirth †Baby-Bender Baby-Bender: The heart's tears do not gain homing.
  • Added in RepentanceBFFS! BFFS!: Fires additional shots in random directions, and leaves larger puddles of creep.
  • Dry Baby Dry Baby / Added in AfterbirthFarting Baby Farting Baby: If you have picked up either of the babies into the first familiar spot before Isaac's Heart, they will block enemy shots before they can hit the heart. Enemies touching the heart can still do damage, and picking up the babies after the heart will cause the heart's hitbox to be checked first against shots.
  • Added in RepentanceGigante Bean Gigante Bean: Increases the knockback amount and radius of the heart when fully charged. Highly useful.
  • Added in Afterbirth †King Baby King Baby: The Heart will follow King Baby. This makes it much harder to avoid damage, but also makes other synergies like Kamikaze! Kamikaze! much easier to use.
  • Added in RepentanceA Pound of Flesh A Pound of Flesh: Consumables can no longer be picked up in Shops.
  • Sharp Plug Sharp Plug: Sharp Plug can no longer be used.
  • The Soul The Soul: Isaac's body repels projectiles, but Isaac's Heart doesn't.
  • Added in Repentance Tainted Forgotten Tainted Forgotten: The heart follows Tainted Soul.

In-game Footage[]

In Rebirth Removed in Repentance[]

In Repentance[]


  • Isaac's Heart while it's following Isaac fittingly shares the same sprite as Child's Heart Child's Heart.
  • The nature of the item is similar to that of a Mask + Heart Mask + Heart enemy.
  • This item is used in The Guardian The Guardian (challenge #30).


Bug Bug! When picked up by Tainted Lazarus after picking up Birthright, the character which has Isaac's Heart can be damaged even in ghost form.



PC TPWZ 7CVR (Treasure Room below of spawn)


PC Normal and hard modes only 7BH9 T4DJ (Treasure Room adjacent to spawn)

PC Y8V7 7K4F (Treasure Room adjacent to spawn)

PS4 W1TD 0BJN (Treasure Room south of spawn)