The VH-mode regime of high confinement has been observed in both DIII-D and JET. VH-mode is characterized by thermal confinement twice that seen in H-mode, with the edge transport barrier penetrating deeper into the plasma. Two mechanisms have been identified as important in achieving this high level of confinement. Expansion of the E*B velocity shear turbulence suppression zone is important in allowing reductions in local transport, while access to the second ballooning stability regime in the edge allows avoidance or elimination of ELMs which impede the confinement improvement. The high performance phase of these discharges is usually terminated by an MHD event which removes energy from a large portion of the plasma cross-section, and is followed by an H-mode phase.