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Once full, you can teleport to the Devil Room (red) or Angel Room (purple). In the Devil Room, you spend one heart container to get a choice of three items. Angel Rooms give a choice of two items but don't require to sacrifice a heart container. Can only pick one in either room. In my experience, Devil Rooms tend to offer more offensive based items while Angel Rooms offer more utility based items. I personally find the Angel Room better because they've given me flying a couple of times and I value that over damage. You may feel differently!
Edit: To make sure it doesn't seem like I'm trying to say that Angel/Wisdom rooms are the best. I have also gotten garbage/situational from them such as Magic Wand (chance to drop crystal when you get hit). The Devil/Violence room gives more options and that on its own is worth something. Similar to Isaac, I would suggest Devil Rooms are more consistent even at the cost.
Also violence rooms have 3 items vs 2 in the wisdom rooms so even more base choice! :)
There's also a fun mechanic with wisdom/violence in the late game but we'd like to leave people to discover it!