Microsoft have explained that they won't be supporting Edit and Continue under the x64 CLR in Visual Studio 2010:
When creating a new Visual C# Console Application in VS2010 for .NET 4.0, the default target settings for the project is to target the x86 platform instead of Any CPU (MSIL) like Visual Studio 2008 does
[...]
Adding true support for EnC to the 64-bit CLR is unfortunately a large work item and other features were prioritized over this given the work around of changing the platform target to x86.
(from http://connect.microsoft.com/VisualStudio/feedback/ViewFeedback.aspx?FeedbackID=455103)
The description on Microsoft Connect makes it appear as though 64-bit Edit and Continue is a major architectural change. My question is: what is different about x64 that makes EnC difficult?
I haven't been able to find much in the way of technical detail on the web, other than "64-bit EnC doesn't work".