When writing plugins for media center your plugin is hosted in ehexthost.exe this exe gets launched from ehshell.exe and you have no way of launchi
I was debugging a C++ plugin in an externally spawned process that crashed by throwing an exception at startup and this worked perfectly for me:
Add the free Reattach Extension for Visual Studio. Ask it to reattach to the process name before it is launched. It will pop a modal dialog saying it is waiting for the process name to launch.
Now launch the process and the Visual Studio debugger will attach immediately, catching exceptions and hitting breakpoints.
(This was also in a media plugin, the exception was normally caught and rethrown by the host process in a Delphi context so I needed to break before that happened).