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Are you familiar with tinted rocks? (Slightly different colored rocks with "x" marks on them?) They give soul hearts when you blow them up.
- Take orbitals to protect you from enemy shots (Meat cube, Ball of bandages, Sac Dagger, pretty flies etc).
- Try to take Angel deals instead of devil deals. Even tho, some devil deals are great for him: Athame (chance to generate black hearts) , Maw of the Void (same as Athame), Dark bum (takes red hearts and gives you spirit hearts), Abaddon, Ceremonial robes etc. Remember that some of these items have to be unlocked first.
- Find Book of Revelations / Satanic Bible / The Relic / Mitre / Serpent's Kiss -- tier A items for Deadboi. Again, you need to unlock most of these.
- Always look out for tinted rocks. You need them as much as you need air IRL when you play with deadboi.
- Get lucky enough for Mom's Knife / Dr fetus / Polyphemus and other OP items in the first item room for ALMOST guaranteed win.
- idk ?!
I just checked your achievements. You still haven't unlocked It Lives according to them, which means you have no reliable way to go to the Cathedral. For now, deal with that. Kill the Heart once more.
Then.
Focus on getting soul/sin heart generation. Book of Revelations, Satanic Bible, Dark Bum are amongst the most reliable ones. Some passives also give you soul/sin hearts when you pick them up, like Squeezy or the Match Book.
Devil Deals are tricky for ???. Some Devil items are incredibly good, but you must reduce your health by 3 hearts... Take only those which give you some soul health, like the Pact (gives you 2 soul hearts on pickup, so it costs 1 in the end). Otherwise, Angel rooms are your friends. Not as good, but heh, if you don't have extra health to spare, it's better than dying.
If it's still too hard, kill Isaac with other characters first in order to unlock the Polaroid. It's a wonderful defensive item for ???.
Good dodging skills are also required obviously, even if you have health generation. Relying only on items to carry you through the game isn't a good strategy in my opinion. It won't make you a better player.
Have fun dying, crying, then dying again. :P
I spent almost 3 hours, to find that perfect run
You need to kill Mom's Heart 11 times for It Lives as wiki says
:P
Find Ankh item.
Die before Isaac fight.
Respawn as Blue Baby and kill this ♥♥♥♥♥♥.