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Active: Blank Card because it is an extremely interesting item that opens up a lot of plays and combos, and can both be used to break the game as well as for normal play to great effect.
If you want a damage item then Mom's Knife is the best standalone damage item for pure damage output, though Epic Fetus is also great and effectively gives you infinite bombs as a bonus.
Active: Satanic Bible. Better than prayer card because it works great with ??? and you don't have to wait for the next floor for it to take affect properly. Gives great survivability and you can easily max your health with itl
Active: Tammy's head. It's kind of broken with it's easy recharge and the effect it can have when used in combination with some tear types.
Active: Blank Card. I just won a run with it, and it was really the only thing holding the run together. It's best when combo'd with Dagaz or Hierophant, but even something like Lovers can work.
Special mentions: Holy Mantle and Shears.
Active - Krampus Head.. Yeah, there are Tammy that can synergize with Brimstone, but that's two items, not one. Blank card is awesome, but you need to get a proper card or rune for it to work. Head just kills stuff - insane damage and long duration allow you to clean entire rooms with it AND deal good damage to bosses.
Active - D6 , Gives loads of good items instead of just being one good.
Active- Krampus Head. A no-brainer
Active-d6
Passive: Dark bum
Tammys head with brimstone is just amazing.
Dark bum - really great. His free spirit hearts make deal with the devil rooms much more likely and thats a game changer.
So many runs saved by this item.
Passive: Dark Bum
Obviously
http://platinumgod.co.uk/dark-bum
THE SYNERGIES
Passive: Dark Bum
http://platinumgod.co.uk/dark-bum