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In Flash Isaac, you could overspend with the devil and go into "debt", meaning you couldn't carry ANY sort of HP until you found enough HP upgrades to repay the devil. In Rebirth, if a devil deal is 2 red hearts while you have 1 red and 3 souls, it'll take 1 red and 1 soul.
By the way, it sounds like you think you die if you have exactly 0 red hearts. Not the case.
i know i dont die but i like to have red hearts. im the person who prefers 12 reds instead of 12 blues. so thats why i want to choose. also when i got 9 red hearts and 3 blue hearts and the boss dropped an hp up im not gonna take it cause it deletes one of my blues. i'd rather spend all 3 blues for devil and then pick up my hp.
Oh yes it is totally possible and amazing. Free brimstone or mom's knife, or dark bum feels so good.
yea when you have dark bum you sure want a choose option lol.
In the current patch, Using black hearts to pay you can basically steal all of the other deals. Taking a spirit heart deal you can't afford with black hearts will only take you down to 1/2 a black heart. If one of those deals gives you soul hearts or black hearts then take them last and you can get the others for free.
Red hearts can be useful late game too, I have came across guppy's paw, 2 of hearts, or a sun card in later floors more then I thought I would and having those red hearts have saved my life.